Urine antimony and risk of cardiovascular disease – A prospective case-cohort study in Danish Non-Smokers
Background: Limited evidence suggests that antimony induces vascular inflammation and oxidative stress and may play a role in cardiovascular disease (CVD) risk. However, few studies have examined whether environmental antimony from sources other than tobacco smoking is related with CVD risk. The gen...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-11-01
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| Series: | Environment International |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0160412023005421 |
| _version_ | 1797615979567513600 |
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| author | Clara G. Sears Erin J. Healy Lissa F. Soares Dana Palermo Melissa Eliot Yaqiang Li Victoria Fruh Tesleem Babalola Katherine A. James James M. Harrington Gregory A. Wellenius Anne Tjønneland Ole Raaschou-Nielsen Jaymie R. Meliker |
| author_facet | Clara G. Sears Erin J. Healy Lissa F. Soares Dana Palermo Melissa Eliot Yaqiang Li Victoria Fruh Tesleem Babalola Katherine A. James James M. Harrington Gregory A. Wellenius Anne Tjønneland Ole Raaschou-Nielsen Jaymie R. Meliker |
| author_sort | Clara G. Sears |
| collection | DOAJ |
| description | Background: Limited evidence suggests that antimony induces vascular inflammation and oxidative stress and may play a role in cardiovascular disease (CVD) risk. However, few studies have examined whether environmental antimony from sources other than tobacco smoking is related with CVD risk. The general population may be exposed through air, drinking water, and food that contains antimony from natural and anthropogenic sources, such as mining, coal combustion, and manufacturing. Objectives: To examine the association of urine antimony with incident acute myocardial infarction (AMI), heart failure, and stroke among people who never smoked tobacco. Methods: Between 1993 and 1997, the Danish Diet, Cancer and Health (DCH) cohort enrolled participants (ages 50–64 years), including n = 19,394 participants who reported never smoking at baseline. Among these never smokers, we identified incident cases of AMI (N = 809), heart failure (N = 958), and stroke (N = 534) using the Danish National Patient Registry. We also randomly selected a subcohort of 600 men and 600 women. We quantified urine antimony concentrations in samples provided at enrollment. We used modified Cox proportional hazards models to estimate adjusted hazard ratios (HR) for each incident CVD outcome in relation to urine antimony, statistically adjusted for creatinine. We used a separate prospective cohort, the San Luis Valley Diabetes Study (SLVDS), to replicate these results. Results: In the DCH cohort, urine antimony concentrations were positively associated with rates of AMI and heart failure (HR = 1.52; 95%CI = 1.12, 2.08 and HR = 1.58; 95% CI = 1.15, 2.18, respectively, comparing participants in the highest (>0.09 µg/L) with the lowest quartile (<0.02 µg/L) of antimony). In the SLVDS cohort, urinary antimony was positively associated with AMI, but not heart failure. Discussion: Among this sample of Danish people who never smoked, we found that low levels of urine antimony are associated with incident CVD. These results were partially confirmed in a smaller US cohort. |
| first_indexed | 2024-03-11T07:34:42Z |
| format | Article |
| id | doaj.art-2dd669ef0713421ea11a52979addafd2 |
| institution | Directory Open Access Journal |
| issn | 0160-4120 |
| language | English |
| last_indexed | 2024-03-11T07:34:42Z |
| publishDate | 2023-11-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Environment International |
| spelling | doaj.art-2dd669ef0713421ea11a52979addafd22023-11-17T05:24:48ZengElsevierEnvironment International0160-41202023-11-01181108269Urine antimony and risk of cardiovascular disease – A prospective case-cohort study in Danish Non-SmokersClara G. Sears0Erin J. Healy1Lissa F. Soares2Dana Palermo3Melissa Eliot4Yaqiang Li5Victoria Fruh6Tesleem Babalola7Katherine A. James8James M. Harrington9Gregory A. Wellenius10Anne Tjønneland11Ole Raaschou-Nielsen12Jaymie R. Meliker13Christina Lee Brown Envirome Institute, Division of Environmental Medicine, Department of Medicine, University of Louisville, Louisville, KY, USA; Department of Epidemiology, Brown University, Providence, RI, USA; Corresponding author at: University of Louisville, 302 E Muhammad Ali Blvd, Louisville, KY 40202, USA.Department of Medical Informatics, Stony Brook University Medical Center, Stony Brook, NY, USAProgram in Public Health, Department of Family, Population, & Preventive Medicine, Stony Brook University, Stony Brook, NY, USAProgram in Public Health, Department of Family, Population, & Preventive Medicine, Stony Brook University, Stony Brook, NY, USADepartment of Epidemiology, Brown University, Providence, RI, USADepartment of Community and Behavioral Health, Colorado School of Public Health, Aurora, CO, USADepartment of Environmental Health, Boston University School of Public Health, Boston, MA, USAProgram in Public Health, Department of Family, Population, & Preventive Medicine, Stony Brook University, Stony Brook, NY, USADepartment of Family Medicine, University of Colorado Denver, Denver, CO, USAAnalytical Science Division, RTI International, Research Triangle Park, NC, USADepartment of Environmental Health, Boston University School of Public Health, Boston, MA, USADanish Cancer Society Research Center, Copenhagen, Denmark; Department of Public Health, University of Copenhagen, Copenhagen, DenmarkDanish Cancer Society Research Center, Copenhagen, Denmark; Department of Environmental Science, Aarhus University, Aarhus, DenmarkProgram in Public Health, Department of Family, Population, & Preventive Medicine, Stony Brook University, Stony Brook, NY, USABackground: Limited evidence suggests that antimony induces vascular inflammation and oxidative stress and may play a role in cardiovascular disease (CVD) risk. However, few studies have examined whether environmental antimony from sources other than tobacco smoking is related with CVD risk. The general population may be exposed through air, drinking water, and food that contains antimony from natural and anthropogenic sources, such as mining, coal combustion, and manufacturing. Objectives: To examine the association of urine antimony with incident acute myocardial infarction (AMI), heart failure, and stroke among people who never smoked tobacco. Methods: Between 1993 and 1997, the Danish Diet, Cancer and Health (DCH) cohort enrolled participants (ages 50–64 years), including n = 19,394 participants who reported never smoking at baseline. Among these never smokers, we identified incident cases of AMI (N = 809), heart failure (N = 958), and stroke (N = 534) using the Danish National Patient Registry. We also randomly selected a subcohort of 600 men and 600 women. We quantified urine antimony concentrations in samples provided at enrollment. We used modified Cox proportional hazards models to estimate adjusted hazard ratios (HR) for each incident CVD outcome in relation to urine antimony, statistically adjusted for creatinine. We used a separate prospective cohort, the San Luis Valley Diabetes Study (SLVDS), to replicate these results. Results: In the DCH cohort, urine antimony concentrations were positively associated with rates of AMI and heart failure (HR = 1.52; 95%CI = 1.12, 2.08 and HR = 1.58; 95% CI = 1.15, 2.18, respectively, comparing participants in the highest (>0.09 µg/L) with the lowest quartile (<0.02 µg/L) of antimony). In the SLVDS cohort, urinary antimony was positively associated with AMI, but not heart failure. Discussion: Among this sample of Danish people who never smoked, we found that low levels of urine antimony are associated with incident CVD. These results were partially confirmed in a smaller US cohort.http://www.sciencedirect.com/science/article/pii/S0160412023005421AntimonyMetalsCardiovascular diseaseMyocardial infarctionHeart failureStroke |
| spellingShingle | Clara G. Sears Erin J. Healy Lissa F. Soares Dana Palermo Melissa Eliot Yaqiang Li Victoria Fruh Tesleem Babalola Katherine A. James James M. Harrington Gregory A. Wellenius Anne Tjønneland Ole Raaschou-Nielsen Jaymie R. Meliker Urine antimony and risk of cardiovascular disease – A prospective case-cohort study in Danish Non-Smokers Environment International Antimony Metals Cardiovascular disease Myocardial infarction Heart failure Stroke |
| title | Urine antimony and risk of cardiovascular disease – A prospective case-cohort study in Danish Non-Smokers |
| title_full | Urine antimony and risk of cardiovascular disease – A prospective case-cohort study in Danish Non-Smokers |
| title_fullStr | Urine antimony and risk of cardiovascular disease – A prospective case-cohort study in Danish Non-Smokers |
| title_full_unstemmed | Urine antimony and risk of cardiovascular disease – A prospective case-cohort study in Danish Non-Smokers |
| title_short | Urine antimony and risk of cardiovascular disease – A prospective case-cohort study in Danish Non-Smokers |
| title_sort | urine antimony and risk of cardiovascular disease a prospective case cohort study in danish non smokers |
| topic | Antimony Metals Cardiovascular disease Myocardial infarction Heart failure Stroke |
| url | http://www.sciencedirect.com/science/article/pii/S0160412023005421 |
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